MAintAin activity in arthritis: a study protocol of the co-development and feasibility testing of a physical activity maintenance intervention [version 1; peer review: 2 approved with reservations]

Background: Despite the wealth of evidence demonstrating the health benefits of physical activity (PA), people with arthritis commonly do not meet recommended PA levels. Whilst various programmes support people with arthritis to become active, most individuals reduce their level of PA after completion of a structured exercise programme. This research aims to co-develop and feasibility test a PA maintenance intervention for those living with arthritis, after exit from a structured exercise programme.

Methods: Intervention development was guided by the INDEX framework for developing complex interventions.
Phase 1, Evidence Synthesis: Bring together existing evidence, clinical guidelines and behavior change theories for PA maintenance in arthritis, to develop an intervention logic model.
Phase 2, Observation and qualitative study: Conduct an observational analysis of a physiotherapy led structured exercise programme for those living with arthritis, to understand what behaviour change components are used and what might support PA maintenance. Followed by a qualitative exploration of PA maintenance barriers, facilitators and strategies for those who have participated in the classes, their family members/friends and the delivering physiotherapist.
Phase 3, Finalise intervention prototype: Results from phases 1 and 2, will be triangulated to inform potential intervention options. Those living with arthritis/key stakeholders will be invited to participatory workshops to refine intervention content and delivery modes.
Phase 4, Feasibility Study: The final phase is a pre-post, mixed methods feasibility evaluation of the newly developed multicomponent PA maintenance intervention for people living with arthritis, after completion of a physiotherapy led structured exercise programme.

Discussion: Intervention development will bring together PA maintenance theory and evidence with user input and other key contextual factors. User input will be achieved by collaboration with two embedded patient researchers and a wider Public Patient Involvement (PPI) panel to ensure diverse patient experiences and perspectives are heard and inform programme design.